Under laws that are the nation's toughest, California on Friday announced 14 penalties totaling $575,000 against 12 hospitals where caregivers put patients in "immediate jeopardy" of harm, such as failing to remove surgical sponges, metal retractors, drill bits, guide wires and a towel.
At a Petaluma hospital, a sponge was not discovered for 1 year and nine months after it was left inside a patient. And at Scripps Memorial in La Jolla, a non-tagged blue towel—used to save an 80-year-old man who was bleeding to death—was not discovered for four months, despite three hospitalizations and a surgery determine why his wound hadn't healed.
Since the laws took effect in 2008 and 2009, 170 fines totaling about $4.8 million have been levied against 112 of the state's 400 hospitals. Of these fines, 39 totaling about $1.2 million are under appeal.
"Information from the incidents that led to these penalties will be used to determine how these deficiencies can be decreased or eliminated over time," said Pam Dickfoss, acting deputy director for the California Department of Public Health. She said the department is working "on multiple fronts with hospitals and patient safety organizations" so hospitals can share safety strategies.
Of the 14 fines, eight were imposed because surgical teams left objects inside patients. In several cases the objects weren't discovered for many months—in one case 21 months—despite patients' complaints of pain.
The funds are to be used for projects that improve patient safety. One $800,000 project will focus on why so many adverse events involve forgotten surgical devices, which state officials say is the second biggest category of immediate jeopardy, accounting for more than 20% of the penalties, state officials said.
"We want California hospitals to be successful in their efforts to reduce hospital acquired infections, decrease medication errors and eliminate surgical error," Dickfoss said.
The amount of fines for each hospital varies depending on when the incident occurred. For those in 2008, fines are $25,000. On Jan. 1, 2009, fines increased to $50,000 for the first violation, $75,000 for the second and $100,000 for third or subsequent violations.
Each hospital has submitted an acceptable plan of correction, state documents said.
California has the toughest immediate jeopardy policy in the nation, says Jill Rosenthal, National Academy for State Health Policy's program director.